Provider Demographics
NPI:1780199539
Name:NGUYEN, QUYNH JENNY (MPH, CHES)
Entity Type:Individual
Prefix:MS
First Name:QUYNH JENNY
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MPH, CHES
Other - Prefix:MS
Other - First Name:JENNY
Other - Middle Name:QUYNH
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MPH, CHES
Mailing Address - Street 1:90 NEW SEASON
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92602-2477
Mailing Address - Country:US
Mailing Address - Phone:714-749-3103
Mailing Address - Fax:
Practice Address - Street 1:7861 GARDEN GROVE BLVD
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92841-4224
Practice Address - Country:US
Practice Address - Phone:714-749-3103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-01
Last Update Date:2017-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
22244174H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
Provider Identifiers
StateIdentifier IDID TypeIssuer
22444OtherNATIONAL COMMISSION FOR HEALTH EDUCATION CREDENTIALING INC.